Free State Liquor Regulations, 2010

This is the version of this Provincial Notice as it was from 2 July 2010 to 13 December 2010. Read the latest available version.

Free State
South Africa
Free State Gambling and Liquor Act, 2010

Free State Liquor Regulations, 2010

Provincial Notice 84 of 2010

Mr MA Dukwana, Member of the Executive Council responsible for Economic Development, Tourism and Environmental Affairs has, by virtue of the powers vested in him by section 71 of the Free State Liquor Act, 2007, made regulations which took effect on 10 June 2010. In terms of section 142(l)(d) of the Free State Gambling and Liquor Act, 2010, any regulations issued in terms of the Free State Liquor Act, 2007, and which may be issued in terms of the Free State Gambling and Liquor Act, 2010, are deemed to have been issued in terms of the latter Act. In order to promote certainty and assist with interpretation of the regulations, the regulations previously published have been aligned with the provisions of the Free State Gambling and Liquor Act, 2010, and are hereby republished as set out in the Schedule.

Chapter I
Definitions

1. Definitions

In these regulations, unless the context otherwise indicates, a word or expression to which a meaning has been assigned in the Act, has the same meaning, and—Act” means the Free State Gambling and Liquor Act, 2010.

Chapter II
Application for a registration certificate in terms of section 27 read with section 31

2. Lodgement

An application envisaged in section 27 read with section 31 for a registration certificate must be lodged during office hours on the first working Friday of the month to the designated office of the Authority.

3. Form of application

(1)An application for a registration certificate as contemplated in regulation 2 must be—
(a)lodged by submitting the original application and two copies thereof;
(b)in accordance with Form FSLA1 in Schedule 1;
(c)accompanied by relevant documents as contemplated in section 31(2) of the Act; and
(d)accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.
(2)The designated office must within seven (7) working days of receiving an application, submit the original and one copy thereof to the Head Office of the Authority.
(3)For the purpose of preparation of a report in accordance with section 31, the local municipality may inspect the premises to which the application relates and do any other investigation the local municipality may deem necessary in accordance with any other law.
(4)The local municipality must within 30 days of receiving an application, submit the report envisaged in subregulation (3) to the Authority.
(5)The Head Office of the Authority must within seven (7) working days of receipt of the application envisaged in regulation 2 from the designated office refer it to the persons envisaged in section 31(3).
(6)If any information stated in the application envisaged in regulation 2 changes, the Authority must notify the local municipality in writing of such changes and the effect thereof prior to consideration of the application and allow the local municipality ten (10) working days to submit comments regarding such changes.

4. Notice of application

(1)The applicant must ensure that the notice of application for registration envisaged in regulation 2 must be published in the Provincial Gazette and at least one newspaper normally circulated in the ward where the premises are situated on the day of submission of the application, substantially in the form of Form FSLA2 in Schedule 1.
(2)Notice of application envisaged in subregulation (1) published in the Provincial Gazette and media must include the full names of the applicant, intended trading names, identity number or registration number of the applicant, full address and location of the premises, the type of registration certification applied for, names and nature of educational institutions, names of and distance to similar registered premises and places of worship, within 500 meter from the premises.
(3)The notice contemplated in subregulation (1) must invite interested persons to lodge an objection in terms of section 33 of the Act.

5. Public inspection of documents

(1)The application envisaged in regulation 2 or any document lodged in terms of the Act or these regulations with the application must also be open to public inspection at the designated office during office hours.
(2)A person must be allowed to obtain copies of the application upon proof of payment of the relevant fees as prescribed in terms of the Promotion of Access to Information Act, 2000 (Act No. 2 of 2000).

6. Objections

A person may lodge an objection to the application envisaged in regulation 2 to the Authority in the following manner:
(a)The objection must be in writing;
(b)The objection must comply with section 33 of the Act, which means that—
(i)full reasons for the objection must be stated;
(ii)the objection must clearly indicate the full name, identity number, residential address, postal address and telephone number, if any, and where applicable, its registration number and address of its office, of the objector; and
(c)The objection must clearly identify the application concerned.

7. Filing of reports by a designated police officer and liquor inspector

(1)Not later than ten (10) working days after the Authority requested a report envisaged in section 31(3) read with regulation 69(1) regarding an application in terms of regulation 2 from the South African Police Service, the designated police officer must submit, in duplicate, his or her written report to the Authority.
(2)The Authority must within seven (7) working days of receipt of the report of the designated police officer refer it to the liquor inspector for the report envisaged in section 31(3).
(3)Not later than ten (10) working days after the Authority requested a report envisaged in section 31(3) read with regulation 69(2) regarding an application envisaged in regulation 2 from a liquor inspector, he or she must submit his or her written report to the Authority.

8. Referral of reports to applicant

(1)The Authority must provide copies of the reports of the local municipality, designated police officer and liquor inspector envisaged to the applicant for comments.
(2)The comments envisaged in subregulation (1) must be submitted by the applicant within 14 working days to the Authority, which must clearly identify the relevant application.

9. Request of further information

Where the Authority required further information from the applicant in terms of section 28(1) of the Act, the applicant must submit such further information within 14 working days from receiving the request for further information to the Authority.

10. Hearing of objections

Hearings contemplated in section 35 of the Act must be recorded and minutes must be kept of the proceedings.

11. Registration certificate

If any application for registration (excluding special events registration) is granted, a registration certificate, substantially in the form of Form FSLA3 in Schedule 1, must be issued.

Chapter III
Application in terms of section 54 for a special events registration certificate

12. Lodgement

An application for a Special Events Registration in terms of section 54 of the Act must be lodged with the designated office of the Authority.

13. Form of application

An application by an applicant referred to in section 54(1) of the Act for a special event registration must be—
(a)lodged by submitting the original application;
(b)in accordance with Form FSLA4 of Schedule 1;
(c)accompanied by comprehensive written representation in support of the application;
(d)accompanied by proof of payment of the prescribed fees; and
(e)accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.

14. Procedure upon receipt of application

(1)The Authority must consider the application for special events registration as envisaged in regulation 12 and may request comments from the relevant local municipality, any other municipality, designated police officer or liquor inspector when the Authority deems it necessary.
(2)The relevant local municipality, any other municipality, designated police officer or liquor inspector must submit comments, if any, within seven (7) working days from receipt of such request.
(3)If comments envisaged in subregulation (2) are negative, those comments must be referred to the applicant to submit his or her comments within seven (7) working days.

15. Procedure upon grant of application for special events

If the Authority grants approval for special events registration—
(a)a registration certificate, substantially in the form of Form FSLA5 in Schedule 1, must be issued; and
(b)the Authority must inform the relevant designated police officer and relevant municipality of the registration.

Chapter IV
Application in terms of section 37 to vary conditions of registration

16. Lodgement of application

An application to vary conditions of registration in terms of section 37 of the Act must be lodged with the designated office of the Authority.

17. Form of application

Every application contemplated in regulation 16 must—
(a)be lodged by submitting the original application;
(b)be in accordance with Form FSLA6 in Schedule 1;
(c)set out clearly which conditions are applicable;
(d)be accompanied by comprehensive written representations in support of the application;
(e)be accompanied by proof of payment of prescribed fees; and
(f)be accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.

18. Procedure upon receipt of application

(1)The Authority must consider the application envisaged in regulation 16 and may request comments from the relevant local municipality or other municipality when the Authority deems it necessary.
(2)When so requested, the relevant local or other municipality must submit its comments, if any, within 14 working days from receipt of such request.
(3)The Authority may request reports as envisaged in section 31(3)(a) and (b) of the Act from the relevant designated police officer and the liquor inspector.

19. Filing of reports by designated police officer and liquor inspector

(1)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 18(3) read with regulation 69(1) regarding the application envisaged in regulation 16 from the South African Police Service, the designated police officer must submit, in duplicate, his or her written report to the Authority.
(2)The Authority must within seven (7) working days of receipt of the report of the designated police officer envisaged in regulation (1) refer it to the liquor inspector for the report envisaged in regulation 18(3).
(3)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 18(3) read with regulation 69(2) with regard to the application to vary conditions of registration from a liquor inspector, he or she must submit his or her written report to the Authority.

20. Referral of reports to applicant

(1)The Authority must provide copies of the reports and comments of the relevant municipality, designated police officer and liquor inspector with regard to the application envisaged in regulation 16 to the applicant for comments.
(2)The comments envisaged in subregulation (1) of the applicant must be submitted within 14 working days to the Authority, which must clearly identify the relevant application.

21. Procedure upon grant of application to vary conditions

If an application to vary conditions of registration is granted, a written approval must be issued substantially in the form of Form FSLA7 in Schedule 1.

Chapter V
Application in terms of section 38 to effect any structural alterations or an extension of registered premises

22. Lodgement of application

An application to effect any structural alteration or extension of registered premises in terms of section 38 of the Act must be lodged with the designated office of the Authority.

23. Form of application

Every application contemplated in regulation 22 must be—
(a)lodged by submitting the original application;
(b)in accordance with Form FSLA8 in Schedule 1;
(c)accompanied by a plan of the applicable portion of such premises on which any proposed structural alteration or extension is indicated in red, clearly showing with reference thereto—
(i)the dimension of each room;
(ii)all doors, windows and counters (where applicable) and means of internal and external communication;
(iii)the street and places to which such means of communication leads;
(iv)how the applicable portion links up with the existing premises;
(d)accompanied by consent of the relevant municipality who approved the building plans for the proposed structural alteration, addition or reconstruction to the registered premises;
(e)accompanied by a description of the applicable portion of the registered premises with reference to the construction, lay-out, furnishing, fixtures, fittings and floor covering, which description shall be contained in a separate document;
(f)accompanied by comprehensive written representations in support of the application; and
(g)accompanied by a declaration under oath or a truly affirmation at the end of the said form that the information contained therein is true.

24. Procedure upon receipt of application

(1)The Authority must consider the application to effect any structural alterations or an extension of registered premises and may request comments from the relevant local municipality or any other municipality when the Board deems it necessary.
(2)When so requested, the relevant local or other municipality must submit its comments, if any, within 14 working days from receipt of such request.
(3)The Authority may request reports as envisaged in section 31(3)(a) and (b) of the Act from the relevant designated police officer and liquor inspector.

25. Filing of reports by designated police officer and liquor inspector

(1)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 24(3) read with regulation 69(1) regarding an application envisaged in regulation 22 from the South African Police Service, the designated police officer must submit, in duplicate, his or her written report to the Authority.
(2)The Authority must within seven (7) working days of receipt of the report of the designated police officer envisaged in subregulation (1) refer it to the liquor inspector for the report envisaged in regulation 24(3).
(3)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 24(3) read with regulation 69(2) regarding an application envisaged in regulation 22 from a liquor inspector, he or she must submit, in duplicate, his or her written report to the Authority.

26. Referral of reports to applicant

(1)The Authority must provide copies of the reports and comments of the relevant municipality, designated police officer and liquor inspector regarding an application envisaged in regulation 22 to the applicant for comments.
(2)The comments envisaged in subregulation (1) of the applicant must be submitted within 14 working days to the Authority, which must clearly identify the relevant application.

27. Procedure upon grant of application

If an application envisaged in regulation 22 is granted, a written approval must be issued substantially in the form of Form FSLA9 in Schedule 1.

Chapter VI
Application in terms of section 39 for the transfer of registration

28. Lodgement of application

An application for the transfer of a registration certificate in terms of section 39 of the Act must be lodged with the designated Office.

29. Form of application

An application for the transfer of a registration certificate must be—
(a)lodged by submitting the original application;
(b)completed by the applicant as prospective holder and the registrant; and
(c)in accordance with Form FSLA10 in Schedule 1;
(d)accompanied by comprehensive written representations in support of the application;
(e)accompanied by proof of payment of prescribed fees; and
(f)accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.

30. Procedure upon receipt of application

(1)The Authority must consider the application for the transfer of registration and may request comments from the relevant local municipality or other municipality when the Authority deems it necessary.
(2)When so requested, the relevant local or any other municipality must submit its comments, if any, within 14 working days from receipt of such request.
(3)The Authority may request reports as envisaged in section 31(3)(a) and (b) of the Act from the relevant designated police officer and liquor inspector.

31. Filing of reports by designated police officer and liquor inspector

(1)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 30(3) read with regulation 69(1) regarding an application envisaged in regulation 28 from the South African Police Service, the designated police officer must submit, in duplicate, his or her written report to the Authority.
(2)The Authority must within seven (7) working days of receipt of the report of the designated police officer envisaged in subregulation (1) refer it to the liquor inspector for the report envisaged in regulation 30(3).
(3)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 30(3) read with regulation 69(2) regarding an application envisaged in regulation 28 from a liquor inspector, he or she must submit his or her written report to the Authority.

32. Referral to applicant

(1)The Authority must provide copies of the reports and comments of the relevant municipality, designated police officer and liquor inspector regarding an application envisaged in regulation 28 to the applicant for comments.
(2)The comments envisaged in subregulation (1) of the applicant must be submitted within 14 working days to the Authority, which must clearly identify the relevant application.

33. Procedure upon grant of application

If the application envisaged in regulation 28 is granted, approval substantially in the form of Form FSLA11 in Schedule 1 must be issued.

Chapter VII
Notification in terms of section 39(3) for obtaining control over registrant

34. Lodgement of application

A person must inform the Authority about obtaining control over registered person as envisaged in section 39(3) of the Act.

35. Form of application

A notification regarding the obtaining of control over registrant must be—
(a)completed by the registrant and the person obtaining control;
(b)in accordance with Form FSLA12 in Schedule 1;
(c)accompanied by proof of payment of prescribed fees; and
(d)accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.

36. Procedure upon receipt of notification

The Authority must consider the notification and, if necessary, take steps in terms of the Act or other legislation, which could include bringing it to the attention of the relevant authority in terms of the Competition Act, 1998 (Act No. 89 of 1998).

Chapter VIII
Application in terms of section 40(3) for the appointment of person to conduct registered activities on an interim basis

37. Lodgement of application

An application for the appointment of a person to conduct registered activities on an interim basis as envisaged in section 40(3) of the Act must be lodged with the designated office of the Authority.

38. Form of application

An application as envisaged in regulation 37 must be—
(a)lodged by submitting the original application;
(b)in accordance with Form FSLA13 in Schedule 1;
(c)accompanied by comprehensive written representations in support of the application;
(d)accompanied by proof that notice was given as envisaged in section 40(4) of the Act;
(e)accompanied by a confirmation that an administrator has not yet been appointed;
(f)accompanied by proof of payment of prescribed fees; and
(g)accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.

39. Procedure upon receipt of application

(1)The Authority must consider the application for the appointment of person to conduct registered activities on an interim basis as envisaged in the Act and may request comments from the relevant local municipality or any other municipality when the Authority deems it necessary.
(2)When so requested, the relevant local or other municipality must submit its comments, if any, within 14 working days from receipt of such request.
(3)The Authority may request reports as envisaged in section 31 (a) and (b) of the Act from the relevant designated police officer and liquor inspector.

40. Filing of reports by designated police officer and liquor inspector

(1)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 39(3) read with regulation 69(1) regarding an application envisaged in regulation 37 from the South African Police Service, the designated police officer must submit, in duplicate, his or her written report to the Authority.
(2)The Authority must within seven (7) working days of receipt of the report of the designated police officer envisaged in subregulation (1), refer it to the liquor inspector for the report envisaged in regulation 39(3).
(3)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 39(3) read with regulation 69(2) from a liquor inspector, he or she must submit, in duplicate, his or her written report to the Authority.

41. Referral to applicant

(1)The Authority must provide copies of the reports and comments of the local municipality, designated police officer and liquor inspector regarding an application envisaged in regulation 37 to the applicant for comments.
(2)The comments envisaged in subregulation (1) of the applicant must be submitted within 14 working days to the Authority, which must clearly identify the relevant application.

42. Procedure upon grant of application

If the application for the appointment of a person to conduct registered activities on an interim basis is granted, approval substantially in the form of Form FSLA14 in Schedule 1 must be issued.

Chapter IX
Application in terms of section 41(2) for the temporary removal of registration

43. Lodgement of application

(1)An application for the temporary removal of a registration must be lodged with the designated office of the Authority.
(2)The notice of application for the temporary removal of a registration must be published in the Provincial Gazette and at least one newspaper circulated in the ward where the premises are to be removed to on the day of submission of the application, substantially in the form of Form FSLA15 in Schedule 1.

44. Form of application

An application for the temporary removal of a registration must be—
(a)lodged by submitting the original application;
(b)in accordance with Form FSLA16 in Schedule 1;
(c)accompanied by comprehensive written representations in support of the application;
(d)accompanied by proof of payment of prescribed fees; and
(e)accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.

45. Procedure upon receipt of application

(1)The Authority must consider the application for the temporary removal of registration as envisaged in the Act and may request comments from the relevant local municipality or any other municipality when the Authority deems it necessary.
(2)When so requested, the relevant local or other municipality must submit its comments, if any, within 14 working days from receipt of such request.
(3)The Authority may request reports as envisaged in section 31(3)(a) and (b) of the Act from the relevant designated police officer and liquor inspector.

46. Filing of reports by designated police officer and liquor inspector

(1)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 45(3) read with regulation 69(1) regarding an application envisaged in regulation 43 from the South African police Service, the designated police officer must submit, in duplicate, his or her written report to the Authority.
(2)The Authority must within seven (7) working days of receipt of the report of the designated police officer envisaged in subregulation (1), refer it to the liquor inspector for the report envisaged in regulation 45(3).
(3)Not later than ten (10) working days after the Authority requested a report envisaged in regulation 45(3) read with regulation 69(2) from a liquor inspector, he or she must submit, in duplicate, his or her written report to the Authority.

47. Referral to applicant

(1)The Authority must provide copies of the objections received, comments and reports of the relevant municipality, designated police officer and liquor inspector regarding an application envisaged in regulation 43 to the applicant for comments.
(2)The comments envisaged in subregulation (1) of the applicant must be submitted within 14 working days to the Authority, which must clearly identify the relevant application.

48. Procedure upon grant of application

If the application for the temporary removal is granted, approval substantially in the form of Form FSLA17 in Schedule 1 must be issued.

Chapter IX
Application in terms of section 27(2) for registration as a micro-manufacturer or authorised dealer of methylated spirits

[Please note: numbering as in original]

49. Lodgement

An application for a registration as a micro-manufacturer or authorised dealer of methylated spirits in terms of section 27(2) of the Act must be lodged with the designated office of the Authority.

50. Form of application

An application by an applicant referred to in section 27(2) of the Act for a micro-manufacturer or authorised dealer registration of methylated spirits must be—
(a)lodged by submitting the original application;
(b)in accordance with Form FSLA18 of Schedule 1;
(c)accompanied by comprehensive written representation in support of the application;
(d)accompanied by proof of payment of the prescribed fees; and
(e)accompanied by a declaration under oath or truly affirmation at the end of the said form that the information contained therein is true.

51. Procedure upon receipt of application

(1)The Authority must consider the application as envisaged in regulation 49 and may request comments from the relevant local municipality, any other municipality, designated police officer or liquor inspector when the Authority deems it necessary.
(2)When so requested, the relevant local municipality, any other municipality, designated police officer or liquor inspector must submit the comments, if any, within ten (10) working days from receipt of such request.
(3)If comments envisaged in subregulation (2) are negative, those comments must be referred to the applicant to submit his or her comments within 14 working days.

52. Procedure upon grant of application for micro-manufacturer or authorised dealer of methylated spirits

If the Authority grants approval for registration envisaged in regulation 49, a registration certificate, substantially in the form of Form FSLA19 in Schedule 1, must be issued.

Chapter XI
Application in terms of section 42 for registration prior to lapsing

53.

Prior to lapsing of registration a registrant may apply for registration as envisaged in section 42 of the Act in the same manner and form applicable to registration of new premises as set out in regulations 2 to 11.

Chapter XII
Notification in terms of section 43 of voluntary cancellation of registration

54.

A registrant must inform the Authority about the voluntary cancellation in writing in which the following information must be submitted:
(a)name of registrant;
(b)certified copy of registration certificate;
(c)reasons for cancellation;
(d)date on which cancellation of registration will take effect.

Chapter XIII
Notification in terms of section 44 of cancellation as consequence of liquidation; sequestration; winding-up or death

55.

(1)The liquidator or trustee must inform the Authority in accordance with section 44(1) of the Act in writing in which the following information must be submitted—
(a)name of registrant;
(b)certified copy of registration certificate;
(c)proof of appointment as liquidator or trustee.
(2)The executor must inform the Authority in accordance with section 44(2) of the Act in writing in which the following information must be submitted—
(a)name of registrant;
(b)certified copy of registration certificate;
(c)certified copy of death certificate.

Chapter XIV
Notices

56. Form of notice

(1)A notice referred to in section 115 must be substantially in the form of Form FSLA20 in Schedule 1.
(2)The Authority may issue a notice to a person substantially in the form of Form FSLA21 contained in Schedule 1 to require such person to be present at the meeting of the Authority.

57. Issue of notice

Every notice must be issued by the Authority through the liquor inspector who must forward the original and one copy thereof to a designated police officer or inspector.

58. Service of notice

(1)Every notice must be served by a police officer or inspector by delivering the original thereof to the person named therein or, if he or she cannot be found, by delivering it at his or her residence or place of employment or business to a person apparently over the age of 16 years and apparently residing or employed there.
(2)A return by a police officer or inspector who served the notice on the copy thereof, that the service thereof has been effected in terms of subregulation (1), must, after service thereof, be forthwith forwarded to the Authority.
(3)The notice must be served on the person mentioned therein so that he or she is in possession thereof at least 14 working days before the date upon which the meeting will take place.

Chapter XV
Records

59. Record keeping by Authority

All records required to be kept by virtue of the Act, must be in writing and must be retained in accordance with provisions of the Provincial Archives Act, 1999 (Act No. 4 of 1999).

60. Records to be kept by certain holders of registration certificate

(1)All holders of off-consumption registration certificates or special events registration certificates must keep records, substantially in the form of Form FSLA22 in Schedule 1, indicating in respect of every sale of liquor by that person to any one customer at any one time in a quantity of 150 litres or more—
(a)the date of sale;
(b)the name, identity number and address of the purchaser; and
(c)the quantity of each kind of liquor sold.
(2)Entry of the particulars referred to in subregulation (1), must be made in such records immediately upon completion of any sale.

61. Record of appointment of natural person

(1)A person other than a natural person who is the holder of a registration, and a natural person who is the holder of a registration must appoint a natural person to manage and be responsible for the business and must submit information regarding that appointment, substantially in the form of Form FSLA23 in Schedule 1 and must—
(a)furnish in the said Form such information as is solicited therein; and
(b)declare under oath or truly affirmation at the end of the said Form that the information contained therein, is true.
(2)The holder of the registration must forthwith forward a copy of Form FSLA23 by registered post to or by delivery by hand to—
(a)the designated office of the Authority; and
(b)the relevant designated police officer.

Chapter XVI
General provisions

62. Form of application

Any written application, any document accompanying such application and any document lodged in terms of the Act or regulations (excluding plans which shall be clear and legible), must be in typescript on A4 standard paper.

63. Responsibility for correctness of notice

The applicant is solely responsible for the correctness of any notice submitted by him or her or his or her representative for publication in accordance with the provisions of these regulations.

64. Publications, advertisements and notices

The notice referred to in regulations 4 and 43(2) must be deemed to be properly published in the Provincial Gazette if the Provincial Government Printer prints a notice in summary form, substantially in the form of Form FSLA2 or FSLA15, as the case may be, in Schedule land errors will not be the responsibility of the Authority.

65. Availability of approvals or authorities

Every approval or authority issued in terms of the Act must be filed together with the registration certificate in the manner envisaged in section 30(4) of the Act.

66. Certificate of appointment of liquor inspector

The certificate of appointment of a liquor inspector must be in writing and in accordance with Form FSLA24 in Schedule 1.

67. Times of business

The times of business in relation to different categories of business are set out in Schedule 4.

68. Complaints

Complaints of persons contemplated in section 132 of the Act must at least contain the following information—
(a)description of type of business conducted at the premises about which complaint is submitted;
(b)address of premises about which complaint is submitted; and
(c)explanation of the facts on which complaint is based.

69. Matters to be included in report of designated police officer and liquor inspector

(1)The report of the designated police officer must include—
(a)information in relation to the criminal record (if any) of applicant;
(b)crime patterns and/or statistics of the area in which the premises are situated if such information are available;
(c)proximity of premises to institutions of learning, places of worship and existing outlets;
(d)the number of registration certificates of the same kind already issued in the near vicinity of the premises;
(e)the suitability of the premises for the intended use thereof as envisaged in the Act;
(f)information from Home Affairs;
(g)any other matter which ought to be taken into consideration in respect of the application.
(2)The report of the liquor inspector must indicate whether and to what extent he or she has—
(a)verified information submitted by the local municipality and designated police officer;
(b)verified information submitted by the applicant;
(c)checked issues of public interest which, inter alia, could include interviews with surrounding owners of premises and business;
(d)any other matter which ought to be taken into consideration in respect of the application.

70. Guidelines regarding proximity and ratio of population

(1)Premises may not be situated within a radius of 500 meters from institutions of learning and places of worship.
(2)The ratio of population vis-a-vis the number of outlets in a ward is 50 households per 1 liquor outlet as envisaged by the Act.
(3)Applicants whose applications will be in contravention of subregulation (1) or (2) must submit representations which specifically indicate the reason their applications should be allowed notwithstanding non-compliance with subregulations (1) and (2).

Chapter XVII
Fees

71. Access to documents

The provisions of the Promotion of Access to Information Act, 2000 (Act No. 2 of 2000), apply to fees for access to documents of the Authority.

72. Application fees

(1)No application referred to in Part A of Schedule 2 may be lodged with the municipality or Authority or considered by the competent authority unless the fees set out in Part B of the said Schedule have been deposited into the account of the Authority.
(2)No amount paid in terms of subregulation (1), or any part thereof, may be refunded to an applicant.

73. Fees payable in respect of the issue of a registration certificate

(1)Within 60 days of the issue of a registration certificate (excluding a special events registration certificate) there must be deposited into the account of the Authority the fees set out in Part A of Schedule 3.
(2)Whenever a registration certificate (excluding a special events registration certificate) is issued after 31 January of any year, the fees payable in respect of the issue of such a registration certificate must be reduced by one twelfth in respect of each completed calendar month which has passed since the preceding 31 December until the date of issue thereof, and if such registration certificate is issued after 30 June of any year, the annual fees in respect of such registration certificate for the whole of the next succeeding year must be paid together with the fees so reduced.

74. Fees payable in respect of the transfer or removal of a registration certificate

Within 60 days of the issue of a certificate of transfer or removal, there must be deposited into the account of the Authority the fees set out in Part B in Schedule 3.

75. Fees payable annually in respect of a registration certificate

There must, for the year following the year during which the Act comes into operation and for every calendar year thereafter, be deposited into the account of the Authority, in respect of each registration certificate (excluding a special events registration certificate), the annual renewal fees set out in Part C of Schedule 3 on or before 31 December, annually.

Chapter XVII
Commencement of regulations

76. Short title and commencement

These regulations are called the Free State Liquor Regulations, 2010.

Schedule 1

Form FSLA1

Form Application in terms of section 27 read with section 31 for registration certificate

______________Date stampFor official useAmount R ____________________Reference No. ________________Date ________________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)ApplicationForm FSLA1
(ii)Building plan of the premises approved by municipalityA
(iii)Detailed description of external and internal features of premisesB
(iv)Comprehensive written representations with specific reference to section 31(2)(a) and Regulation 70C
(v)Proof of notices required by section 31(1)(d)D
(vi)Proof of payment of prescribed feeE
(vii)Certified copy of the identity document or certified proof in the case of trust, consortium, partnership or other legal entityF
Application prepared by ________________________________________________Postal address _________________________________________________________Telephone No. __________________________________________________________
1.
(a)Full names of applicant ____________________________________________
(b)Age ____________________________________________
(c)Identity number or in the case of a company or close corporation, its registration number ____________________________________________
(d)Residential address or address of registered office ____________________________________________
(e)Business address and location of the premises to which the application relates ____________________________________________
(f)Postal address _______________________________________________________
(g)Business telephone number ____________________________________________[Delete (b) if applicant is not a natural person]
2.
(a)Is applicant—
(i)a person who has been convicted of a contravention of this Act or any other liquor legislation within the three years immediately preceding the date of application?Yes __________ No __________
(ii)a person who has been convicted, under applicable legislation, of an offence the elements of which are inconsistent with the objects and purposes of this Act, at any time—
(a)after the coming into operation of this Act; and
(b)within the three years immediately preceding the date of application.Yes __________ No __________
(iii)an unrehabilitated insolvent?Yes __________ No __________
(b)If the applicant is a company, close corporation, partnership or trust, state whether a person contemplated in subparagraph (a)—
(i)has a controlling interest in such a company, close corporation or trustYes __________ No __________
(ii)is a partner in such a partnershipYes __________ No __________
(iii)is the main beneficiary under such a trust(Mark the applicable square)Yes __________ No __________
(c)If any of the questions in subparagraphs (a) or (b) have been replied to in the affirmative, provide full details(Use an annexure if necessary)
3.
(a)State the names, identity number and address of each person, including the applicant, who will have any financial interest in the business and in each case the nature and extent of such interest. [If the applicant is a public company, statutory institution or a co-operative as contemplated in the Co-operations Act, 1981 (Act 91 of 1981), it shall be sufficient if only the name and postal address of such company, statutory institution or co-operative, as the case may be, the name of each director (if any) thereof and the nature and extent of the financial interest of such company, statutory institution or co-operative are furnished and not also the interests of individual members of such company, statutory institution or co-operative ______________________________________________________________________ ______________________________________________________________________________________________________ (Use an annexure if necessary)
(b)State the financial interest in the liquor trade in the Province of the applicant and if the applicant is a private company, close corporation, partnership or trust, also of every shareholder, member or partner thereof or beneficiary thereunder. (If the applicant or the said shareholder, member, partner or beneficiary has no such interest, this fact must be specifically mentioned) ______________________________________________________________________ ______________________________________________________________________________________________________ (Use an annexure if necessary)
4.
(a)State kind of registration applied for ____________________________________________
(b)State what applicant intends selling thereunder/what applicant intends to manufacture ________________________________________________________________________________________
5.If application is made for a micro-manufacturer's registration for the production of wine only—
(a)Is applicant—
(i)a person who engages in viticulture?Yes __________ No __________
(ii)an association of person, the majority of the members of which engages in viticulture?Yes __________ No __________
(iii)a co-operative society, which manufactures wine from grapes produced by members of the co-operative society and of which no other such co-operative society is a member?Yes __________ No __________
(b)describe the location of the premises where the liquor concerned is manufactured with reference to the erf, street or farm number _________________________________________________________________________(Delete paragraph 5 if not applicable)(Mark the applicable square)
6.If application is made for a micro-manufacturer's registration—
(a)is applicant a person who—
(i)engages in viticulture?Yes __________ No __________
(ii)manufactures any other fermented beverage?Yes __________ No __________
(b)describe the situation of the premises where the liquor reference to the erf, street or farm number _________________________________________________________________________________________
(Delete paragraph 6 if not applicable)(Mark the applicable square)
7.Under what name is the business to be conducted? ______________________________________________
8.
(a)Describe the location of the premises where the business is to be conducted with reference to the erf, street or farm number ____________________________________________________________________________________________
(b)In which municipality is the premises referred to in subparagraph (a), situated? ____________________________________________________________________________________________
9.Will applicant have the right to occupy the premises referred to in paragraph 8, including such place on other premises upon which any approval is to be exercised, for the purposes of the registration applied for? (Mark the applicable square)Yes __________ No __________
10.In the case of an application for an on-consumption registration, state in which portion of the premises the sale of liquor is to take place ____________________________________________________________________________________________
11.
(a)Is application made in respect of premises which—
(i)have not yet been erected?Yes __________ No __________; or
(ii)are already erected, but require additions or alterations to make them suitable for the purposes of the proposed business?Yes __________ No __________; or
(iii)are already erected and, in the applicant's opinion, do not require additions or alterations in order to make them suitable for such purposes?Yes __________ No __________
(b)If paregraph 11(a)(i) or (ii) applies, state—
(i)the date on which such erection, additions or alterations will be commenced with; and ____________________________________________________________________________________________
(ii)the period which will be required for the erection, additions or alterations ____________________________________________________________________________________________
12.In the case of a club liquor registration, attach a copy of the rules of the club, certified by the president, chairman or secretary thereofAnnexure ______________________________________________________I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA2

Notice of intention to apply in terms of section 27 read with section 31 for registration

Free State Gambling and Liquor Act, 2010
Notice is hereby given that ______________________ intends to lodge an application on ______________________ particulars of which appear hereunder.
123456
MunicipalityFull, names, street and postal address of applicant and identity no. or registration no.Kind of registration applied forKind of product to be sold/manufacturedName under which business is to be conducted and full address of premisesName of, nature of and distance to institutions of learning, similar registered premises and places of worship
      
Any person may, within 21 days from _________________________________ (date of publication in Provincial Gazette) lodge in terms of section 33 of the Free State Gambling and Liquor Act, 2010 an objection in writing to the Free State Liquor Authority (address set out hereunder). The objection must clearly indicate the full names, identity number, residential address, postal address and telephone number, if any, and where applicable, its registration number and address of its office, of the objector. The objection must also identify the application to which it relates. The application may be inspected at the offices of the Authority during their office hours. The address of the relevant Office of the Liquor Authority is: ___________________________________________________________________________________________________________________Place _________________________________Signature of applicant or person authorized to sign application __________________________________________________________________Date _________________________________Footnote:Complete columns as follows:(1)Column 1.-State the local municipality in which the premises are situated.(2)Column 2.- State surname of applicant followed by his or her full first name, residential, business and postal address and identity number. If the applicant is not a natural person, state the full names of such person, followed by the address of its registered office and registration number.(3)Column 3.- State the kind of registration applied for with due regard to section 46, and in the case of sorghum beer registration, state whether it is intended to sell liquor for consumption on or off the premises.(4)Column 4.- State kind of product to be sold/manufactured.(5)Column 5.- State the name under which business is to be conducted and describe the situation of the premises where the business is to be conducted with reference to the erf, street or farm number, including such place on other premises upon which any approval is to be exercised.(6)Column 6.- State the name of, nature of and distance to institutions of learning, similar registered premises and places of worship within 500 meter from the premises.

Form FSLA3

Registration certificate

Reference No. _____________Free State Gambling and Liquor Act, 2010__________________________________________________________________ _________________________________ REGISTRATION _________________________________ is hereby registered to sell/manufacture* ________________________________ (state kind of product) and to conduct under the name of __________________________________________________________________ upon premises, the plan of which has been approved, situated at _________________________________ in the local municipality of _________________________________ such business as is, in accordance with the conditions set out in terms of the Act or any other law, authorized to be conducted under the abovementioned registration.This registration shall be subject to the conditions determined by the Free State Gambling and Liquor Authority in terms of the Free State Gambling and Liquor Act, 2010, as well as conditions contained in said Act. The conditions determined are set out in Annexure _________________________________ hereto.Liquor not required for immediate sale, shall be stored on the registered premises.This registration shall be of no force and effect unless the prescribed registration fees have been paid into the bank account of the Free State Gambling and Liquor Authority and proof thereof has been submitted to the Free State Gambling and Liquor Authority. Payment of the prescribed fees is to be made within sixty days after the undermentioned date of issue.
Date of issuePrescribed feesPayable on or before
   
_________________________________Person acting under power of the Free State Gambling and Liquor Authority*Delete part which is not applicable

Form FSLA4

Application in terms of section 54 for a special events registrations certificate

______________Date stampFor official useAmount R __________________Reference No. ______________Date ______________________
Free State Gambling and Liquor Act, 2010
Index
 Description of document 
(i)ApplicationForm FSLA4
(ii)Comprehensive written representationsA
(iii)Proof of payment of prescribed feesB
Application prepared by ________________________________________________Postal address _________________________________________________________Telephone no. __________________________________________________________
1.
(a)Full names of applicant ____________________________________________
(b)Age ____________________________________________
(c)Identity number or in the case of a company or close corporation, its registration number ____________________________________________
(d)Residential address or address of registered office ____________________________________________
(e)Business address and location of the premises to which the application relates ____________________________________________
(f)Postal address ____________________________________________
(g)Business telephone number ____________________________________________ [Delete (b) if applicant is not a natural person]
2.If applicant is not a natural person, state the names, identity number and address of each shareholder, member, partner or beneficiary ________________________________________________________________________________________
3.
(a)Is applicant a registrant in terms of the Free State Gambling and Liquor Act, 2010? (Mark the applicable square) Yes ________________ No ________________
(b)If subparagraph (a) has been replied to in the affirmative, state—
(i)the kind of registration ________________________________________
(ii)the kind of liquor which may be sold thereunder ________________________________________
(iii)under what name the registered business is conducted ________________________________________
(iv)describe the situation of the premises where the registered business is conducted with reference to the erf, street or farm number ________________________________________________________________________________
(c)In the case of an application by the holder of a club liquor registration certificate, state whether the special events registration certificate is required for a bona fide public function on the premises of the club in respect of which he or she is registered—
(i)which is connected with any game, match, competition or social occasion which forms part of the activities normally taking place on the premises Yes ________________ No ________________; or
(ii)for which no suitable facilities are reasonably available at any place other than the premises of the club in the near vicinity (Delete the subparagraphs which are not applicable) (Mark the applicable square)Yes ________________ No ________________
4.
(a)If applicant is not the holder of a registration certificate referred to in paragraph 3—
(1)on behalf of what or who does applicant apply? ________________________________________________________________________________
(2)what position does applicant hold in institution? ________________________________________________________________________________
(b)Is applicant a person who—
(i)a person who has been convicted of a contravention Act or any other liquor legislation within the three immediately preceding the date of application? Yes ________________ No ________________
(ii)a person who has been convicted, under applicable legislation, of an offence the elements of which are inconsistent with the objects and purposes of this Act, at any time—
(a)after the coming into operation of this Act; and
(b)within the three years immediately preceding the date of application. Yes ________________ No ________________
(iii)is an unrehabilitated insolvent? Yes ________________ No ________________
(iv)is a minor? Yes ________________ No ________________
(c)If any of the questions in subparagraph (b) have been replied to in the affimnative, provide full details ________________________________________________________________________________(Use an annexure if necessary)
5.State the nature of the occasion in respect of which a special events registration certificate is required ________________________________________________________________________________
6.Describe the situation of the premises where the business is to be conducted with reference to the erf, street or farm number ________________________________________________________________________________
7.Will applicant have the right to occupy the premises referred to in paragraph 6 for the purposes of the registration? (Mark the applicable square)Yes ________________ No ________________
8.
(a)Except in the case of an application by the holder of a club liquor registration certificate, has a special events registration certificate previously been granted to the applicant? Yes ________________ No ________________
(b)If answer is yes in 8(a), state the number of days in respect of which such registration was granted since January of the relevant year ________________________________________________________________________________
9.Describe the place or places on the premises in which the sale of liquor is to take place ________________________________________________________________________________
10.State the dates upon and the hours during which such sale will take place ________________________________________________________________________________I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA5

Special events registration certificate

Free State Gambling and Liquor Act, 2010

Reference No. _____________________________________________________________________________________________________________________being the ______________________________________________________________________________ is hereby registered to sell _______________________________________ and to conduct such business as is, in accordance with the conditions of the Act or any other law, authorized to be conducted under the above-mentioned certificate at _______________________________________ place(s) from where such liquor is to be sold at ______________________________________________________________________________ in the local municipality of _______________________________________ between the hours of ________________________ and _________________ on the following dates _____________________________________________________________________________________________________________________This certificate shall be subject to the conditions determined by the Free State Gambling and Liquor Authority in terms of the Free State Gambling and liquor Act, 2010, annexed hereto as Annexure _______________________________________ and the conditions set out in the said Act.The registration shall be of no force and effect unless the prescribed registration fees, R_______________________________________, have been paid into the bank account of the Free State Gambling and Liquor Authority and proof thereof has been submitted to the Free State Gambling and Liquor Authority.Place _______________________________________Person acting on behalf of the Free State Gambling and Liquor Authority _______________________________________Date of issue _______________________________________

Form FSLA6

Application in terms of section 37 to vary conditions of registration

______________Date stampFor official useAmount R ________________Reference no. ________________Date ________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)ApplicationForm FSLA6
(ii)Copy of registration certificate and conditions of registrationA
(iii)Description of the conditions of registration that should be variedB
(iv)Comprehensive written representationsC
(v)Proof of payment of prescribed feesD
Full names of registrant (applicant) ______________________________________Application prepared by____________________________________________________Postal address_____________________________________________________________Telephone no. _____________________________________________________________I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of by the applicant/person authorized to sign application who acknowledged that—(i)he/she knows and understands the contents of this declaration;(ii)he/she has no objection to taking the prescribed oath/affirmation; and(iii)he/she considers the prescribed oath to be binding on his/her conscience,and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA7

Approval to vary conditions of registration

Free State Gambling and Liquor Act, 2010

Date: _________________________ Reference No. _________________________Approval is granted to _________________________ (registrant) to vary conditions of registration in respect of____________________________________________________________________________________________________________________________________________________________________________________________________________________________The new conditions of registration are attached hereto as Annexure _____________________________________________________________________________________________________On behalf of Free State Gambling and Liquor Authority

Form FSLA8

Application in terms of section 38 to effect structural alterations or an extension of registered premises

______________Date stampFor official useAmount R _________________Reference no. _____________Date _____________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)ApplicationForm FSLA8
(ii)Plan of the premises as set out in Regulation 23A
(iii)Description of the applicable portion of the premises as set out in Regulation 23B
(iv)Comprehensive written representationsC
(v)Copy of registration certificateD
(vi)Proof of payment of prescribed feesE
(vii)Consent of relevant municipality as set out in Regulation 23F
Full names of registrant (applicant) ________________________________________________Application prepared by________________________________________________Postal address_____________________________________________________________Telephone no. _______________________________________________________________I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of by the applicant/person authorized to sign application who acknowledged that—(i)he/she knows and understands the contents of this declaration;(ii)he/she has no objection to taking the prescribed oath/affirmation; and(iii)he/she considers the prescribed oath to be binding on his/her conscience,and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA9

Approval to effect structural alternations or extension of registered premises

Free State Gambling and Liquor Act, 2010

Date _______________________________________ Reference No. _______________________________________Approval is granted to _______________________________________ (registrant) to effect structural alterations to registered premises / extend the registered premises* in respect of ________________________________________________________________________________________________________________________________________________________________________________________________________________________The structural alterations to / extension* of the registered premises that are approved is attached hereto as Annexure ___________________________________________________________________________________________________________________________________________________On behalf of Free State Gambling and Liquor Authority*Delete part which is not applicable

Form FSLA10

Approval to effect structural alternations or extension of registered premises

______________Date stampFor official useAmount R ________________Reference No. ________________Date ________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)ApplicationForm FSLA10
(ii)Comprehensive written representationsA
(iii)Proof of payment of prescribed feesB
Application prepared by ____________________________________________________________Postal address ____________________________________________________________Telephone no. ____________________________________________________________

Part A – Information relating to the applicant who is the registrant

1.Full names of registrant _____________________________________________
2.If applicant is not a natural person, state the names, identity number and address of each shareholder, member, partner or beneficiary _____________________________________________________________________________________________________________________________________________________________________________________________
3.Under what name is the registered business conducted? ________________________________________________
4.
(a)Describe the situation of the premises where the registered business is conducted with reference to the erf, street or farm number _______________________________________________________
(b)In which municipality is the premises referred to in subparagraph (a), situated? ___________________________________________________________________________________________________
________________________________________________________________________________________________________
5.What is reason for transfer of registration? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________I declare/truly affirm that the information furnished in Part A and B of this application in so far as it relates to me/the applicant on whose behalf I am authorized to sign the application, is true.Date _______________________________________________________Signature of applicant who is the holder of the registration or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _______________________________________Business address _______________________________________Designation _______________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Part B – Information relating to the applicant who is the prospective holder

1.
(a)Full names of applicant ________________________________________________
(b)Age _________________________________________________________
(c)Identity number or in the case of a company or close corporation, its registration number _________________________________________________________
(d)Residential address or address of registered office _________________________________________________________
(e)Business address and location of the premises to which the application relates _________________________________________________________
(f)Postal address _________________________________________________________
(g)Business telephone number _________________________________________________________[Delete (b) if applicant is not a natural person]
2.If applicant is not a natural person, state the names, identity number and address of each shareholder, member, partner or beneficiary ________________________________________________________________________________________________________________________________________________________________________________________________
3.
(a)Is applicant a person who—
(i)a person who has been convicted of a contravention of this Act or any other liquor legislation within the three years immediately preceding the date of application? Yes ___________ No ___________
(ii)a person who has been convicted, under applicable legislation, of an offence the elements of which are inconsistent with the objects and purposes of this Act, at any time—
(a)after the coming into operation of this Act; and
(b)within the three years immediately preceding the date of application. Yes ___________ No ___________
(iii)an unrehabilitated insolvent? Yes ___________ No ___________
(iv)is a minor? Yes ___________ No ___________
(b)If the applicant is a company, close corporation, partnership or trust, state whether'a person contemplated in subparagraph (a)—
(i)has a controlling interest in such a company, close corporation or trust Yes ___________ No ___________
(ii)is a partner in such a partnership Yes ___________ No ___________
(iii)is the main beneficiary under such a trust (Mark the applicable square) Yes ___________ No ___________
(c)If any of the questions in subparagraphs (a) or (b) have been replied to in the affirmative, provide full details(Use an annexure if necessary)
4.
(a)State the names, identity number and address of each person—
(i)who, including the applicant, has any financial interest in the business to which the registration relates; and
(ii)who, including the applicant, will have such interest if the application is granted,
and in each case, the nature and extent of such interest. [In the case of a public company, statutory institution or a co-operative as contemplated in the Co-operatives Act, 1981 (Act 91 of 1981), it shall be sufficient if only the name and postal address of such company, statutory institution or co-operative, as the case may be, the name of each director (if any) thereof and the nature and extent of the financial interest of such company, statutory institution or cooperative are furnished and not also the interests of individual members of such company, statutory institution or co-operative.] __________________________________________________________(Use an annexure if necessary)
(b)State the financial interest in the liquor trade in the Province of the applicant and if the applicant is a private company, close corporation, partnership or trust, also of every shareholder, member or partner thereof or beneficiary thereunder. (If the applicant or the said shareholder, member, partner or beneficiary has no such interest, this fact must be specifically mentioned.) __________________________________________________________________________________________________________________________________________________(Use an annexure if necessary)
(c)If the application relates to a liquor store registration, sorghum beer brewer's registration or sorghum beer registration for off-consumption, is the applicant—
(i)a producer or his or her agent? Yes ___________ No ___________
(ii)a manufacturer of beer or his or her agent? Yes ___________ No ___________
(iii)a person who has a financial interest in the business of a producer or a manufacturer of beer, or the agent of such a person? Yes ___________ No ___________
(iv)a company in which shareholders having a financial interest in the business of a manufacturer of beer, together hold a controlling interest, or the agent of such a company? Yes ___________ No ___________
(v)a company in which a company contemplated in subparagraph (e)(iv) holds a controlling interest, or the agent of such a company? Yes ___________ No ___________
(Delete subparagraph (c) if not applicable)(Mark the applicable square)
5.If application is made for the transfer of a micro-manufacturer's registration for the production of wine only, is applicant—
(i)a person who engages in viticulture? Yes ___________ No ___________
(ii)an association of persons the majority of the members of which engages in viticulture? Yes ___________ No ___________
(iii)a co-operative society, which manufactures wine from grapes produced by members of the co-operative society and of which no other such co-operative society is a member? Yes ___________ No ___________
(Delete paragraph 5 if not applicable)(Mark the applicable square)
6.If application is made for the transfer of a producer's registration, is applicant a person who—
(i)engages in viticulture? Yes ___________ No ___________
(ii)manufactures any other fermented beverage? Yes ___________ No ___________
(Delete paragraph 6 if not applicable)(Mark the applicable square)
7.Under what name is the business to be conducted? _________________________________
8.Will applicant have the right to occupy the premises referred to in paragraph 4(a) of Part A of the application, including such place on other premises upon which any approval or determination is exercised, for the purposes of the registration? (Mark the applicable square) Yes ___________ No ___________I declare/truly affirm that the information furnished in Part B of this application in so far as it relates to me/the applicant on whose behalf I am authorized to sign the application and in the documents attached to it, is trueDate _______________________________________________________Signature of applicant who is the prospective hoider or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA11

Approval in terms of section 39 for the transfer of registration

Date _______________________________________ Reference No. _____________________

Free State Gambling and Liquor Act, 2020

The _______________________________________ registration certificate, held by _______________________________________ in respect of premises situated at ______________________________________________________________________________ in the local municipality of ______________________________________________________________________________, under which business is conducted under the name of ______________________________________________________________________________, is hereby transferred to ______________________________________________________________________________ The business will in future be conducted under the name of ______________________________________________________________________________This registration shall be of no force and effect unless the prescribed registration fees have been paid into the bank account of the Free State Gambling and Liquor Authority and proof thereof has been submitted to the Free State Gambling and Liquor Authority. Payment of the prescribed fees is to be made within sixty days after the undermentioned date of issue.
Date of issuePrescribed feesPayable on or before
   
_______________________________________On behalf of Free State Gambling and Liquor Authority

Form FSLA12

Notification in terms of section 39(3) regarding procuring of a controlling interestover the registrant

________________Date stampFor official useAmount R ________________Reference No. ________________Date ________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)NotificationForm FSLA12
(ii)Comprehensive written representationsA
(iii)Proof of payment of prescribed feesB
Application prepared by ____________________________________________________________Postal address ____________________________________________________________Telephone no. ____________________________________________________________

Part A – Information relating to the registrant

1.Full names of registrant _________________________________________________________________________
2.If applicant is not a natural person, state the names, identity number and address of each shareholder, member, partner or beneficiary __________________________________________________________________________________
3.Under what name is the registered business conducted? ____________________________________________
4.
(a)Describe the situation of the premises where the registered business is conducted with reference to the erf, street or farm number ________________________________________________________________________________
(b)In which municipality is the premises referred to in subparagraph (a), situated? ______________________________________________________________________________________________________
I declare/truly affirm that the information furnished in Part A and B of this application in so far as it relates to me/the applicant on whose behalf I am authorized to sign the application, is true.Date _______________________________________________________Signature of applicant who is the holder of the registration certificate or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _________________________________________________Office held if appointment is ex officio _______________________________________

Part B – Information relating to the person who obtained control (applicant)

1.
(a)Full names of applicant ____________________________________________
(b)Age ________________________________________________________________
(c)Identity number or in the case of a company or close corporation, its registration number ____________________________________________
(d)Residential address or address of registered office ____________________________________________
(e)Business address and location of the premises to which the application relates ____________________________________________
(f)Postal address ____________________________________________
(g)Business telephone number ____________________________________________[Delete (b) if applicant is not a natural person]
2.If applicant is not a natural person, state the names, identity number and address of each shareholder, member, partner or beneficiary _______________________________________________________________________________________________________________________________________________________________________________________________
3.What other category of registration does applicant hold?_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4.
(a)Is applicant a person who—
(i)a person who has been convicted of a contravention of this Act or any other liquor legislation within the three years immediately preceding the date of application? Yes ___________ No ___________
(ii)a person who has been convicted, under applicable legislation, of an offence the elements of which are inconsistent with the objects and purposes of this Act, at any time—
(a)after the coming into operation of this Act; and
(b)within the three years immediately preceding the date of application. Yes ___________ No ___________
(iii)an unrehabilitated insolvent? Yes ___________ No ___________
(iv)is a minor? Yes ___________ No ___________
(b)If the applicant is a company, close corporation, partnership or trust, state whether a person contemplated in subparagraph (a)—
(i)has a controlling interest in such a company, close corporation or trust Yes ___________ No ___________
(ii)is a partner in such a partnership Yes ___________ No ___________
(iii)is the main beneficiary under such a trust (Mark the applicable square) Yes ___________ No ___________
(c)If any of the questions in subparagraphs (a) or (b) have been replied to in the affirmative, provide full details (Use an annexure if necessary)
5.
(a)State the names, identity number and address of each person—
(i)who, including the applicant, has any financial interest in the business to which the registration relates; and
(ii)who, including the applicant, will have such interest if the application is granted, and in each case, the nature and extent of such interest. [In the case of a public company, statutory institution or a co-operative as contemplated in the Co-operatives Act, 1981 (Act 91 of 1981), it shall be sufficient if only the name and postal address of such company, statutory institution or co-operative, as the case may be, the name of each director (if any) thereof and the nature and extent of the financial interest of such company, statutory institution or cooperative are furnished and not also the interests of individual members of such company, statutory institution or co-operative.] ___________________________________________________________
(Use an annexure if necessary)
(b)State the financial interest in the liquor trade in the Province of the applicant and if the applicant is a private company, close corporation, partnership or trust, also of every shareholder, member or partner thereof or beneficiary thereunder. (If the applicant or the said shareholder, member, partner or beneficiary has no such interest, this fact must be specifically mentioned.) ___________________________________________________________(Use an annexure if necessary)
(c)If the application relates to a liquor store registration, sorghum beer brewer's registration or sorghum beer registration for off-consumption, is the applicant—
(i)a producer or his or her agent? Yes ___________ No ___________
(ii)a manufacturer of beer or his or her agent? Yes ___________ No ___________
(iii)a person who has a financial interest in the business of a producer or a manufacturer of beer, or the agent of such a person? Yes ___________ No ___________
(iv)a company in which shareholders having a financial interest in the business of a manufacturer of beer, together hold a controlling interest, or the agent of such a company? Yes ___________ No ___________
(v)a company in which a company contemplated in subparagraph (c)(iv) holds a controlling interest, or the agent of such a company? Yes ___________ No ___________
(Delete subparagraph (c) if not applicable)(Mark the applicable square)
I declare/truly affirm that the information furnished in Part B of this application in so far as it relates to me/the applicant on whose behalf I am authorized to sign the application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant who is the proposed person or person authorized to sign application ____________________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of _____________________ by the applicant who is the proposed person/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _______________________________________Business address _______________________________________Designation _______________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA13

Application in terms of section 40(3) for the appointment of a person to conduct registered activities pending appointment of administrator

________________Date stampFor official useAmount R ________________Reference No. ________________Date ________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)ApplicationForm FSLA13
(ii)Copy of registration certificateA
(iii)Comprehensive written representationsB
(iv)Proof of notices required by section 40(4)(a)C
(v)Confirmation that an Administrator has not yet been appointedD
(vi)If proposed appointment is a registrant submit a separate sheet setting out details of such registrationE
(vii)Proof of payment of prescribed feesF
Application prepared by ____________________________________________________________Postal address ____________________________________________________________Telephone no. ____________________________________________________________
1.Full names of applicant ____________________________________________________________
2.If applicant is not a natural person, state the names, identity number and address of each shareholder, member, partner or beneficiary ____________________________________________________________
3.
(a)Under what name is the registered business conducted? ____________________________________________________________
(b)
(i)Will the name change? Yes _________ No___________(Mark applicable square)
(ii)If so, state new name ________________________________________
4.
(a)Describe the situation of the premises where the registered business is conducted with reference to the erf, street or farm number ____________________________________________________________
(b)Describe the situation of the premises where the business is to be conducted with reference to the erf, street or farm number? ____________________________________________________________
5.State for what period this approval is required ____________________________________________________________I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _______________________________________Business address _______________________________________Designation _______________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA14

Approval in terms of section 40 (3) for the appointment of a person to conduct registered activities pending appointment of administrator

Reference No. _______________________________________

Free State Gambling and Liquor Act, 2010

Approval is granted that the _______________________________________ registration in respect of premises situated at _______________________________________ and upon which business is conducted under the name of _______________________________________ is hereby temporarily transferred to __________________________________________________________________ (name of person)The appointment is permitted for the period _______________________________________________________________The determinations, consent, approvals and authorities which have been granted are set out in Annexure(s) _______________________________________ hereto.This approval shall be subject to the conditions determined by the Free State Gambling and Liquor Authority in terms of the Free State Gambling and Liquor Act, 2010 as set out in Annexure _______________________________________ and any conditions set out in said Act._______________________________________On behalf of Free State Gambling and Liquor Authority

Form FSLA15

Notice of intention to apply in terms of section 41 for the temporary removal of registration

Free State Gambling and Liquor Act, 2010
Notice is hereby given that ____________________________ intends to lodge an application for temporary removal of registration, particulars of which appear hereunder, with the Free State Gambling and Liquor Authority.
12345
Full names, street and postal address of applicantKind of registration to be transferredKind of product to be sold/manufacturedFull address of registered premises and local municipality in which situatedName under which business is to be conducted and full address of other premises
     
 
Any person may lodge an objection within 21 days from _________________ (date of publication in Provincial Gazette) in writing to the Free State Gambling and Liquor Authority. The objection must clearly indicate the full names, identity number, residential address, postal address and telephone number, if any, and where applicable, its registration number and address of its office, of the objector. The objection must also identify the application to which it relates. The application may be inspected at the offices of the Free State Gambling and Liquor Authority during its office hours at the following address:____________________________________________________________________________________________________________________________________________________________________________________________________________________Objections must be submitted to:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Place __________________________________________________Signature of applicant or person authorized to sign application ____________________________________Date __________________________________________Footnote:Complete columns as follows:(i)Column 1.-State surname of applicant followed by his or her full first names, residential, business and postal address. If applicant is not a natural person, state the full names of such person followed by the address of its registered office.(ii)Column 2.-State the kind of registration to be removed with due regard to section 42, and in the case of a sorghum beer license, state whether liquor is sold for consumption on or off the registered premises.(iii)Column 3.-State the kind of product to be sold/manufactured.(iv)Column 4.-Describe the situation of the premises where the registered business is conducted with reference to the erf, street or farm number and state the local municipality in which it is situated.(v)Column 5.-State the name under which business is to be conducted and describe the situation of the premises where the business is to be conducted with reference to the erf, street or farm number, including such place on other premises upon which any approval or determination is to be exercised.

Form FSLA16

Application in terms of section 41 for the temporary removal of registration

________________Date stampFor official useAmount R ___________________Reference No. ______________Date _______________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)ApplicationForm FSLA16
(ii)Plan of the premisesA
(iii)Description of the premisesB
(iv)Comprehensive written representationsC
(v)Proof of notices required by section 43(2)D
(vi)Proof of payment of prescribed feesE
 
Application prepared by ___________________________________________________Postal address ____________________________________________________________Telephone no. _____________________________________________________________
1.Full names of applicant ____________________________________________________________
2.If applicant is not a natural person, state the names, identity number and address of each shareholder, member, partner or beneficiary __________________________________________________________________________________________________________________________________________________________________________________________________________
3.
(a)Under what name is the registered business conducted? ______________________________________________________
(b)
(i)Will the name change as a result of the removal? Yes _________ No___________ (Mark applicable square)
(ii)If so, state new name ________________________________________
4.
(a)Describe the situation of the premises where the registered business is conducted with reference to the erf, street or farm number ____________________________________________________________
(b)Describe the situation of the premises where the business is to be conducted with reference to the erf, street or farm number ____________________________________________________________
5.
(a)Are the premises referred to in paragraph 4(a) and (b) in the same municipality? (Mark applicable square) Yes _________ No___________
(b)State the shortest distance by road from the premises referred to in paragraph 4(a) to the premises referred to in paragraph 4(b) ____________________________________________________________
6.In the case of a micro-manufacturer's registration for the production of wine only, describe the situation of the premises where the liquor concerned is manufactured with reference to the erf, street or farm number ____________________________________________________________
7.In the case of a producer's registration, describe the situation of the premises where the liquor concerned is manufactured with reference to the erf, street or farm number ___________________________________________
8.Will applicant have the right to occupy the premises referred to in paragraph 4(b), including such place on other premises upon which any approval or determination is to be exercised, for the purposes of the registration? (Mark applicable square) Yes _________ No___________
9.In the case of an application for the temporary removal of an on~consumption registration, state in which portion of the premises the sale of liquor is to take piace ____________________________________________________________
10.
(a)is application made in respect of premises which—
(i)have not yet been erected? Yes _________ No___________; or
(ii)are already erected, but require additions or alterations to make them suitable for the purposes of the proposed business? Yes _________ No___________; or
(iii)are already erected and, in the applicant's opinion, do not require additions or alterations in order to make them suitable for such purposes? Yes _________ No ___________
(b)if paragraph 10(a)(i) or (ii) applies, state—
(i)the date on which such erection, additions, or alterations will be commenced with ____________________________________________________________; and
(ii)the period which will be required for the erection, additions or alterations ___________________________________________________________________________________________
_________________________________________________________________________________________________
11.State for what period such removal is desired _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
And that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA17

Approval for temporary removal in terms of section 41 of registration

Reference No. _______________________

Free State Gambling and Liquor Act, 2010

The _______________________ registration granted in respect of premises situated at _______________________ and upon which business is conducted under the name of ______________________________________________, is hereby temporarily removed to premises situated at _______________________ in the local municipality of ______________________________________________ where business will be conducted under the name of ___________________________________________________________________________________________________________The temporary removal is permitted for the period ________________________________________________________________________The determinations, consent, approvals and authorities which have been granted are set out in Annexure(s) _______________________ hereto.This approval shall be subject to the conditions determined by the Free State Gambling and Liquor Authority in terms of the Free State Gambling and Liquor Act, 2010 as set out in Annexure _______________________ and any conditions set out in said Act.Liquor not required for immediate sale shall be stored on the registered premises/at a place indicated in Annexure _______________________ hereto.This registration shall be of no force and effect unless the prescribed registration fees have been paid into the bank account of the Free State Gambling and Liquor Authority and proof thereof has been submitted to the Free State Gambling and Liquor Authority. Payment of the prescribed fees is to be made within sixty days after the undermentioned date of issue.
Date of issuePrescribed feesPayable on or before
   
______________________________________________________On behalf of Free State Gambling and Liquor Authority

Form FSLA18

Application in terms of section 27(2) for micro-manufacturer or authorised dealer of methylated spirits registration certificate

________________Date stampFor official useAmount R ________________Reference No. ________________Date ________________
Free State Gambling and Liquor Act, 2010
Index
 Description of documentAnnexure
(i)ApplicationForm FSLA18
(ii)Plan of the premises approved by the municipalityA
(iii)Comprehensive written representationsB
(iv)In the case of authorized dealer an indication where methylated spirits will be heldC
(v)Proof of payment of prescribed feesD
(vi)Certified copy of the identity document or certified proof in the case of trust, consortium, partnership or other legal entityF
Application prepared by ___________________________________________________Postal address ____________________________________________________________Telephone No. _____________________________________________________________
1.
(a)Full names of applicant ____________________________________________________________
(b)Age ______________________________________________________________
(d)Identity number or in the case of a company or close corporation, its registration number ______________________________________________________________
(d)Residential address or address of registered office ____________________________________________________
(e)Business address and location of the premises to which the application relates ______________________________________________________________________________________________________
(f)Postal address _________________________________________________________________________________
(g)Business telephone number ______________________________________________________________________________[Delete (b) if applicant is not a natural person]
2.
(a)Is applicant—
(i)a minor? Yes _________ No___________
(ii)a person who has been convicted of a contravention of this Act or any other liquor legislation within the three years immediately preceding the date of application? Yes _________ No___________
(iii)a person who has been convicted, under applicable legislation, of an offence the elements of which are inconsistent with the objects and purposes of this Act, at any time—
(a)after the coming into operation of this Act; and
(b)within the three years immediately preceding the date of application.
Yes _________ No___________
(iv)an unrehabilitated insolvent? Yes _________ No___________
(b)If the applicant is a company, close corporation, partnership or trust, state whether a person contemplated in subparagraph (a)—
(i)has a controlling interest in such a company, close corporation or trust Yes _________ No___________
(ii)is a partner in such a partnership Yes _________ No___________
(iii)is the main beneficiary under such a trust Yes _________ No___________ (Mark the applicable square)
(c)If any of the questions in subparagraphs (a) or (b) have been replied to in the affirmative, provide full details(Use an annexure if necessary)
3.
(a)State the names, identity number and address of each person, including the applicant; who will have any financial interest in the business and in each case the nature and extent of such interest. [If the applicant is a public company, statutory institution or a co-operative as contemplated in the Co-operatives Act, 1981 (Act 91 of 1981), it shall be sufficient if only the name and postal address of such company, statutory institution or co-operative, as the case may be, the name of each director (if any) thereof and the nature and extent of the financial interest of such company, statutory institution or co-operative are furnished and not also the interests of individual members of such company, statutory institution or cooperative ____________________________________________________________________(Use an annexure if necessary)
(b)State the financial interest in the liquor trade in the Province of the applicant and if the applicant is a private company, close corporation, partnership or trust, also of every shareholder, member or partner thereof or beneficiary thereunder. (If the applicant or the said shareholder, member, partner or beneficiary has no such interest, this fact must be specifically mentioned) ___________________________________________________________(Use an annexure if necessary)
4.State kind of registration applied for _________________________________________________________________
5.If application is made for a micro~manufacturer's registration—
(a)is applicant a person who—
(i)engages in viticulture? Yes _________ No___________
(ii)manufactures any other fermented beverage? Yes _________ No___________
(b)Describe the situation of the premises where the liquor concerned is manufactured with reference to the erf, street or farm number _________________________________________________________________
(Delete paragraph 6 if not applicable)(Mark applicable square)
6.Under what name is the business to be conducted? _________________________________________________________________
7.
(a)Describe the situation of the premises where the business is to be conducted with reference to the erf, street or farm number _________________________________________________________________
(b)In which municipality is the premises referred to in subparagraph (a), situated? _________________________________________________________________
8.Will applicant have the right to occupy the premises referred to in paragraph 9, including such place on other premises upon which any approval is to be exercised, for the purposes of the registration applied for? (Mark the applicable square)Yes _________ No___________
9.
(a)Is application made in respect of premises which—
(i)have not yet been erected? Yes _________ No___________; or
(ii)are already erected, but require additions or alterations to make them suitable for the purposes of the proposed business? Yes _________ No___________; or
(iii)are already erected and, in the applicant's opinion, do not require additions or alterations in order to make them suitable for such purposes? Yes _________ No___________
(b)If paragraph 9(a)(i) or (ii) applies, state—
(i)the date on which such erection, additions or alterations will be commenced with; and
(ii)the period which will be required for the erection, additions or alterations
Yes _________ No___________
I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of applicant or person authorized to sign application _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names _____________________________________________Business address _______________________________________Designation ____________________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA19

Registration certificate: micro-manufacture or authorised dealer of methylated spirits

Reference No. ___________________

Free State Gambling and Liquor Act, 2010

____________________________________________________ REGISTRATION ____________________________________ is hereby registered to sell/manufacture methylated spirits and to conduct under the name of _________________________________________________________________________________________________________________Upon premises, the plan of which has been approved, situated at ________________________________________________________ in the local municipality of ________________________________________________________ such business as is, in accordance with the conditions set out in terms of the Act or any other law, authorized to be conducted under the abovementioned registration.The determinations, consent, approvals and authorities which have been granted are set out in Annexure(s) ________________________________________________________ hereto.This registration shall be subject to the conditions determined by the Free State Gambling and Liquor Authority in terms of the Free State Gambling and Liquor Act, 2010, as well as conditions contained in said Act. The conditions determined are set out in Annexure _______________________________________________________ hereto.This registration shall be of no force and effect unless the prescribed registration fees have been paid into the bank account of the Free State Gambling and Liquor Authority and proof thereof has been submitted to the Free State Gambling and Liquor Authority. Payment of the prescribed fees is to be made within sixty days after the undermentioned date of issue.
Date of issuePrescribed feesPayable or before
   
_______________________________________________________Person acting under power of the Free State Gambling and Liquor Authority

Form FSLA20

Compliance notice

Free State Gambling and Liquor Act, 2020

Date ____________________ Reference No. ____________________To: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
1.Please take notice that the inspector/police officer named below states that you have failed to comply with the following provisions of the Free State Gambling and Liquor Act, 2010 and its regulations as set out on attached sheet (Annexure _____________________).
2.The particulars of your failure to comply are as set out on the attached sheet (Annexure _____________________).
3.You are hereby required to take the actions, or cease the actions, set out in the attached sheet, within the time specified in respect of each of them (Annexure _____________________).
4.Failure to comply with this notice may result in anyone or more of the following penalties:
4.1Prosecution in terms of section 128(2)(e) of the Free State Gambling and Liquor Act, 2010, for the offence of failure to comply with this notice, for which the penalty upon conviction is a fine or imprisonment for a term not exceeding 10 years, or to both a fine and imprisonment.
4.2Prosecution for an offence in terms of section 128 of the Free State Gambling and Liquor Act, 2010, for which the penalty upon conviction is a fine or imprisonment for a term not exceeding 10 years, or to both a fine and imprisonment.
4.3Cancellation of your registration held under registration number _____________________ for failure to comply with this notice, in terms of section 42 of the Free State Gambling and Liquor Act, 2010.
_____________________Name of Liquor Inspector or Police Officer

Form FSLA21

Notice in terms of regulation 52(2) of the Free State Gambling and Liquor Act, 2010, to be present at a meeting of the Free State Gambling and Liquor Authority

Free State Gambling and Liquor Act, 2010

Reference No. _____________________To:
Name:
Address:
Sex:Age:Id no:
By virtue of the powers vested in the Free State Gambling and Liquor Authority by Regulation 52(2) of the Act, you are hereby directed to be present at a meeting of the Free State Gambling and Liquor Authority which relates to ______________________________________________________ and which will be held on the date, time and at the place indicated below.
DateTimePlace
   
Your attention is drawn to the following:
(i)It is compulsory for you to appear in person. If you are unable to appear in person you may appoint an advocate, attorney or any other person to appear on your behalf.
(ii)It is an offence not to be present and to remain in attendance, without you having appointed somebody to appear on your behalf.
(iii)The Free State Gambling and Liquor Authority may require from you to give evidence or to produce any document or any other thing which is in your possession or custody or under your control.
Place of issue __________________________________________________________ Date _______________________________On behalf of the Free State Gambling and Liquor Authority

For Official use only

I certify that I have served this notice upon the said person by delivering a true copy to __________________________________________________________ PERSONALLY; orDelivering as he/she could not be found, a true copy to __________________________________________________________ apparently over the age of 16 years and apparently residing or employed at the place of RESIDENCE/EMPLOYMENT/BUSINESS of the said ____________________________________________________________________________________________________At _______________________________________________________________________________________________________________________________________________________________________________________________________________________The nature and exigency of this notice was explained to the recipient thereof.Time ________________________ Day _________________________ Month __________________________ 20 _____________________________________________________Signature of Police Officer or Liquor Inspector

Form FSLA22

Record of liquor sales of 150 litres or more

______________________________________________Name of registrant

Free State Gambling and Liquor Act, 2010

To whom soldQuantity sold in litres
Names and identity no.AddressSpiritsFortified wineNatural wineBeerOtherDate of sale
        
        
        
        
        
        
        

Form FSLA23

Application in terms of regulation 61 of a natural person to manage and be responsible for the business to which the registration relates

________________Date stampReference no. ________________
Free State Gambling and Liquor Act, 2010
Index
 Description of document 
(i)AppointmentForm FSLA23
Form completed by ________________________________________________________Postal address ___________________________________________________________Telephone no. ____________________________________________________________
1.Under what name is the registered business conducted? ____________________________________________________________
2.In which local municipality is the premises referred to in paragraph 1 situated?________________________ _______________________________________________________________________________________________________________
3.State the following particulars of person whose appointment has been terminated (if applicable):
(a)Full names _____________________________________________
(b)Identity number _____________________________________________
(c)Date of termination of appointment _____________________________________________
4.State the following particulars of person now appointment:
(a)Full names _____________________________________________
(b)Age ____________________________________________________
(c)Identity number _____________________________________________
(d)Relationship between him or her and the person who is the holder of the license _______________________________________________________________
(e)Is applicant—
(i)A minor? Yes ___________ No ___________
(ii)a person who has been convicted of a contravention of this Act or any other liquor legislation within the three years immediately preceding the date of application? Yes ___________ No ___________
(iii)a person who has been convicted, under applicable legislation, of an offence the elements of which are inconsistent with the objects and purposes of this Act, at any time—
(a)afier the coming into operation of this Act; and
(b)within the three years immediately preceding the date of application Yes ___________ No ___________
(iv)an unrehabilitated insolvent? Yes ___________ No ___________
(v)the spouse of a person contemplated in subparagraphs (ii), (iii) and (iv)? Yes ___________ No ___________ (Mark the applicable square)
(vi)domiciled in the Republic of South Africa (Mark the applicable square) Yes ___________ No ___________
(f)If any of the questions in subparagraph (e) have been replied to in the affirmative, provide full details (Use an annexure if necessary)
(g)Date of appointment: ____________________________________________
I declare/truly affirm that the information furnished in this application and in the documents attached to it, is true.Date _______________________________________________________Signature of holder of the license or person authorized to sign Form _______________________________________________________I certify that this declaration has been signed and sworn to/affirmed before me at _____________________ this ____________________ day of ____________________ by the applicant/person authorized to sign application who acknowledged that—
(i)he/she knows and understands the contents of this declaration;
(ii)he/she has no objection to taking the prescribed oath/affirmation; and
(iii)he/she considers the prescribed oath to be binding on his/her conscience,
and that he/she uttered the following words:'I swear that the contents of this declaration are true, so help me God'./'I truly affirm affirm that the contents of this declaration are true'._______________________________________Commissioner of OathsFull names ________________________________________Business address __________________________________Designation _______________________________________Area for which appointment is held _______________________________________Office held if appointment is ex officio _______________________________________

Form FSLA24

Inspector's certificate

Free State Gambling and Liquor Act, 2000

Date __________________ Reference No. ________________The Free State Gambling and Liquor Authority responsible for Economic Affairs hereby appoints _________________________________________________________________________________________________________________________________________________________________________________________________________________________________to be an Inspector for the purposes of the Free State Gambling and Liquor Act, 2010, to investigate complaints in terms of the Act, to monitor and enforce compliance with the Act, and to perform any other functions and exercise any other powers conferred on an Inspector in terms of the Free State Gambling and Liquor Act, 2010.__________________________________________________MEC responsible for Gambling and Liquor Matters

Schedule 2

Fees payable in respect of applications

Part APart B
Nature of applicationFees payable
Application in terms of section 27 read with section 31 for registration (excluding a special event and methylated spirits registration): 
- Accommodation establishment, except guesthouse2500
- Accommodation establishment: Guesthouse1750
- Restaurant1500
- Club1500
- Tavern1250
- Night Club2500
- Gambling establishment2500
- Liquor store1500
- Grocer's wine750
- Micro-manufacturing of liquor2500
Application in terms of section 54 for special events registration1000
Application in terms of section 37 for variation of conditions of registration500
Application in terms of section 38 for alteration or extension of registered premises500
Application in terms of section 39(3) to procure a controlling interest in the business to which the registration relates500
Application in terms of section 39 or 41 for the transfer or removal of registration: 
- Accommodation establishment788
- Restaurant750
- Club750
- Tavern625
- Night Club1250
- Gambling establishment1250
- Liquor store750
- Grocer's wine375
- Micro-manufacturing of liquor1250
Application in terms of section 40(3) for the appointment of a person to conduct registered activities pending appointment of Administrator500
Application in terms of section 27(2) for registration as a micro-manufacturer of methylated spirits750
Application in terms of section 27(2) for registration as authorized dealer of methylated spirits.750
Application in terms of regulation 61 of a natural person to manage and be responsible for the business for the business to which the registration relates500

Schedule 3

Fees payable in respect of registration certificates

RegistrationPart APart BPart C
 Fees payable in respect of a new registrationFees payable in respect of the transfer of registrationAnnual registration fees
Accommodation establishment, except guesthouse17507883500
Accommodation establishment: Guesthouse250012505000
Restaurant15007503000
Club15007503000
Tavern12506252500
Night Club250012505000
Gambling establishment250012505000
Liquor store/ authorized dealer of methylated spirits15007503000
Grocer's wine7503755000
Micro-manufacturing of liquor/methylated spirits250012505000
Special events registration1000N/AN/A

Schedule 4

Times of business

Type of businessBusiness hours
Accommodation establishment10:00 - 00:00
Restaurant10:00 - 00:00
Tavern14:00 - 00:00
Club10:00 - 22:00
Night club18:00 - 04:00
Gambling establishment (excluding casino)10:00 - 04:00
Casino08:00 - 06:00
Special eventAs determined by registration certificate
Liquor store:(a) Wholesale(b) Other liquor store08:00 - 18:0008:00 - 18:00
Grocer's wine08:00 - 20:00
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